Multispecific antigen-binding molecules and uses thereof

ABSTRACT

The present invention provides multispecific antigen-binding molecules and uses thereof. The multispecific antigen-binding molecules comprise a first antigen-binding domain that specifically binds a target molecule, and a second antigen-binding domain that specifically binds an internalizing effector protein. The multispecific antigen-binding molecules of the present invention can, in some embodiments, be bispecific antibodies that are capable of binding both a target molecule and an internalizing effector protein. In certain embodiments of the invention, the simultaneous binding of the target molecule and the internalizing effector protein by the multispecific antigen-binding molecule of the present invention results in the attenuation of the activity of the target molecule to a greater extent than the binding of the target molecule alone. In other embodiments of the invention, the target molecule is a tumor associated antigen, and the simultaneous binding of the tumor associated antigen and the internalizing effector protein by the multispecific antigen-binding molecule of the present invention causes or facilitates the targeted killing of tumor cells.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit under 35 U.S.C. §119(e) of U.S.provisional application Nos. 61/610,494, filed on Mar. 14, 2012;61/721,831, filed on Nov. 2, 2012; and 61/751,286, filed on Jan. 11,2013, the disclosures of which are herein incorporated by reference intheir entireties.

FIELD OF THE INVENTION

The present invention relates to the field of therapeutic proteins, andin particular, to the field of therapeutic proteins that are capable ofinactivating, blocking, attenuating, eliminating and/or reducing theconcentration of one or more target molecules in vitro or in vivo.

BACKGROUND

Therapeutic treatments often require the inactivation or blocking of oneor more target molecules that act on or in the vicinity of a cell. Forexample, antibody-based therapeutics often function by binding to aparticular antigen expressed on the surface of a cell, or to a solubleligand, thereby interfering with the antigen's normal biologicalactivity. Antibodies and other binding constructs directed againstvarious cytokines (e.g., IL-1, IL-4, IL-6, IL-13, IL-22, IL-25, IL-33,etc.), or their respective receptors, for instance, have been shown tobe useful in treating a wide array of human ailments and diseases.Therapeutic agents of this type typically function by blocking theinteraction between the cytokine and its receptor in order to attenuateor inhibit cellular signaling. In certain contexts, however, it would betherapeutically beneficial to inactivate or inhibit the activity of atarget molecule in a manner that does not necessarily involve blockingits physical interaction with another component. One way in which suchnon-blocking attenuation of a target molecule could be achieved would beto reduce the extracellular or cell surface concentration of the targetmolecule. Although genetic and nucleic acid-based strategies forreducing the amount or concentration of a given target molecule areknown in the art, such strategies are often fraught with substantialtechnical complications and unintended side effects in therapeuticsettings. Accordingly, alternative non-blocking strategies are needed tofacilitate the inactivation or attenuation of various target moleculesfor therapeutic purposes.

BRIEF SUMMARY OF THE INVENTION

The present invention is based, at least in part, on the concept ofattenuating or inactivating a target molecule by facilitating orbringing about a physical linkage between the target molecule and aninternalizing effector protein. Through this type of physicalintermolecular linkage, the target molecule can be forced to beinternalized into the cell along with the internalizing effectorprotein, and processed by the intracellular degradative machinery, orotherwise attenuated, sequestered, or inactivated. This mechanismrepresents a novel and inventive strategy for inactivating orattenuating the activity of a target molecule without necessarilyblocking the interaction between the target molecule and its bindingpartners.

Accordingly, the present invention provides a multispecificantigen-binding molecule that is capable of simultaneously binding atarget molecule (T) and an internalizing effector protein (E). Morespecifically, the present invention provides a multispecificantigen-binding molecule comprising a first antigen-binding domain (D1),and a second antigen-binding domain (D2), wherein D1 specifically bindsT, and D2 specifically binds E, and wherein the simultaneous binding ofT and E by the multispecific antigen-binding molecule attenuates theactivity of T to a greater extent than the binding of T by D1 alone. Theenhanced attenuation of the activity of T may be due to the forcedinternalization/degradation of T through its physical linkage to E;however, other mechanisms of action are possible and are not excludedfrom the scope of the present invention.

In addition, the present invention provides methods of using themultispecific antigen-binding molecule to inactivate or attenuate theactivity of a target molecule (T). In particular, the present inventionprovides a method for inactivating or attenuating the activity of T bycontacting T and an internalizing effector protein (E) with amultispecific antigen-binding molecule, wherein the multispecificantigen-binding molecule comprises a first antigen-binding domain (D1)and a second antigen-binding domain (D2), wherein D1 specifically bindsT, and wherein D2 specifically binds E; and wherein the simultaneousbinding of T and E by the multispecific antigen-binding moleculeattenuates the activity of T to a greater extent than the binding of Tby D1 alone.

In certain embodiments of the present invention, D1 and/or D2comprise(s) at least one antibody variable region. For example, themultispecific antigen-binding molecule can, in some embodiments, be abispecific antibody, wherein D1 comprises an antibody heavy and lightchain variable region (HCVR/LCVR) pair that specifically binds T, andwherein D2 comprises an HCVR/LCVR pair that specifically binds E.Alternatively, D1 and/or D2 may comprise a peptide or polypeptide thatspecifically interacts with the target molecule (T) and/or theinternalizing effector protein (E). For example, if the target moleculeis a cell surface receptor, then D1 may comprise a portion of a ligandthat specifically binds the cell surface receptor target molecule.Similarly, if the internalizing effector protein is a cell surfaceinternalizing receptor, then D2 may comprise a portion of a ligand thatspecifically binds the cell surface internalizing receptor. In certainembodiments, D1 comprises an antibody variable region that specificallybinds T, and D2 comprises a peptide or polypeptide that specificallybinds E. In yet other embodiments, D1 comprises a peptide or polypeptidethat specifically binds T, and D2 comprises an antibody variable regionthat specifically binds E. In any configuration, however, the end resultis that T and E are capable of being physically linked, directly orindirectly, via the simultaneous binding of T and E by a multispecificantigen-binding molecule.

Other embodiments will become apparent from a review of the ensuingdetailed description.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1 (panels A-D) provides schematic representations of four generalexemplary mechanisms of action for the multispecific antigen bindingmolecules of the present invention. In each illustrated configuration D1is a first antigen-binding domain; D2 is a second antigen bindingdomain; T is a target molecule; E is an internalizing effector protein;and R is a receptor which internalizes upon binding E. Panel A depictsthe situation in which both T and E are membrane-associated. Panel Bdepicts the situation in which T is soluble and E ismembrane-associated. Panel C depicts the situation in which T ismembrane-associated and E is a soluble protein that interacts with, andis internalized into the cell via the interaction of E and R. Panel Ddepicts the situation in which T is soluble and E is a soluble proteinthat interacts with, and is internalized into the cell via theinteraction of E and R.

FIG. 2 shows the results of an immunoprecipitation experiment performedon two different cells (Cell-1 expressing FcγR1 alone, and Cell-2expressing Krm2 and FcγR1) following incubation for different amounts oftime (0, 15, 30 and 60 minutes) with a DKK1-mFc multispecificantigen-binding molecule.

FIG. 3 shows the relative IL-4-induced luminescence produced byStat6-luc reporter HEK293 cells in the presence and absence of ananti-IL-4R/anti-CD63 multispecific antigen binding protein (“abconjugate”) or control constructs (“control 1” and “control 2”) atvarious concentrations of IL-4.

FIG. 4 shows the results of an experiment carried out in the same manneras the experiment shown in FIG. 3, except that CD63 expression wassignificantly reduced in the reporter cell line by an siRNA directedagainst CD63.

FIG. 5 shows the results of an experiment carried out in a similarmanner as the experiments shown in FIGS. 3 and 4, except that thereporter cells were incubated with the multispecific antigen bindingprotein (“Ab conjugate”) or control constructs (“control 1” and “control2”) for 2 hours or overnight prior to the addition of IL-4 ligand. Thetop row of bar graphs represent the results of experiments conducted incells expressing normal levels of CD63 (“untransfected”), while thebottom row of bar graphs represents the results of experiments conductedin cells in which CD63 expression was significantly reduced in thereporter cell line by an siRNA directed against CD63.

FIG. 6 shows the results of an experiment carried out in a similarmanner as the experiments shown in FIGS. 3 and 4, except that thereporter cells were incubated with the anti-IL-4R/anti-CD63multispecific antigen binding protein (“Ab conjugate”) or controlconstructs (“control 1” and “control 2”) for 15 minutes, 30 minutes, 1hour or 2 hours prior to the addition of IL-4 ligand.

FIG. 7 shows the results of an experiment in which Stat6-luc reportercells were treated with 10 pM IL-4 in the presence of various dilutionsof an anti-IL-4R×anti-CD63 bispecific antibody (“bispecific”), orcontrol constructs (anti-IL-4R monospecific, or mock bispecific thatonly binds IL-4R).

FIG. 8 shows the results of experiments in which HEK293 cells weretreated with a SOST construct labeled with a myc tag and a pH-sensitivelabel (that produces a fluorescent signal at low pH), along with thevarious mono-specific and bispecific antibodies as shown. Results areexpressed in terms of number of fluorescent spots (i.e., labeledvesicles) per cell. Panel A shows the results following incubation onice for 3 hours, panel B shows the results following 1 hour incubationat 37° C., and panel C shows the results following 3 hours incubation at37° C.

FIG. 9 shows the results of experiments in which HEK293 cells weretreated with fluorescently-labeled lipopolysaccharide (LPS) from E. coli(Panel A) or S. minnesota (Panel B), along with an anti-CD63×anti-LPSbispecific antibody, control antibodies, or LPS only, for various times,followed by quenching of non-internalized (i.e., surface bound)fluorophore. Fluorescent signal therefore reflects internalized LPSunder the various conditions shown. Results are expressed in terms ofnumber of fluorescent spots (i.e., labeled vesicles) per cell.

DETAILED DESCRIPTION

Before the present invention is described, it is to be understood thatthis invention is not limited to particular methods and experimentalconditions described, as such methods and conditions may vary. It isalso to be understood that the terminology used herein is for thepurpose of describing particular embodiments only, and is not intendedto be limiting, since the scope of the present invention will be limitedonly by the appended claims.

Unless defined otherwise, all technical and scientific terms used hereinhave the same meaning as commonly understood by one of ordinary skill inthe art to which this invention belongs. As used herein, the term“about,” when used in reference to a particular recited numerical value,means that the value may vary from the recited value by no more than 1%.For example, as used herein, the expression “about 100” includes 99 and101 and all values in between (e.g., 99.1, 99.2, 99.3, 99.4, etc.).

Although any methods and materials similar or equivalent to thosedescribed herein can be used in the practice or testing of the presentinvention, the preferred methods and materials are now described. Allpatents, applications and non-patent publications mentioned in thisspecification are incorporated herein by reference in their entireties.

Multispecific Antigen-Binding Molecules

The present inventors have surprisingly discovered that a targetmolecule's activity can be attenuated by linking the target molecule toan internalizing effector protein via a multispecific antigen-bindingmolecule.

Accordingly, the present invention provides multispecific antigenbinding molecules comprising a first antigen-binding domain (alsoreferred to herein as “D1”), and a second antigen-binding domain (alsoreferred to herein as “D2”). D1 and D2 each bind different molecules. D1specifically binds a “target molecule”. The target molecule is alsoreferred to herein as “T”. D2 specifically binds an “internalizingeffector protein”. The internalizing effector protein is also referredto herein as “E”. According to the present invention, the simultaneousbinding of T and E by the multispecific antigen-binding moleculeattenuates the activity of T to a greater extent than the binding of Tby D1 alone. As used herein, the expression “simultaneous binding,” inthe context of a multispecific antigen-binding molecule, means that themultispecific antigen-binding molecule is capable of contacting both atarget molecule (T) and an internalizing effector protein (E) for atleast some period of time under physiologically relevant conditions tofacilitate the physical linkage between T and E. Binding of themultispecific antigen-binding molecule to the T and E components may besequential; e.g., the multispecific antigen-binding molecule may firstbind T and then bind E, or it may first bind E first and then bind T. Inany event, so long as T and E are both bound by the multispecificantigen-binding molecule for some period of time (regardless of thesequential order of binding), the multispecific antigen-binding moleculewill be deemed to “simultaneously bind” T and E for purposes of thepresent disclosure. Without being bound by theory, the enhancedinactivation of T is believed to be caused by the internalization anddegradative rerouting of T within a cell due to its physical linkage toE. The multispecific antigen-binding molecules of the present inventionare thus useful for inactivating and/or reducing the activity and/orextracellular concentration of a target molecule without directlyblocking or antagonizing the function of the target molecule.

According to the present invention, a multispecific antigen-bindingmolecule can be a single multifunctional polypeptide, or it can be amultimeric complex of two or more polypeptides that are covalently ornon-covalently associated with one another. As will be made evident bythe present disclosure, any antigen binding construct which has theability to simultaneously bind a T and an E molecule is regarded as amultispecific antigen-binding molecule. Any of the multispecificantigen-binding molecules of the invention, or variants thereof, may beconstructed using standard molecular biological techniques (e.g.,recombinant DNA and protein expression technology), as will be known toa person of ordinary skill in the art.

Antigen-Binding Domains

The multispecific antigen-binding molecules of the present inventioncomprise at least two separate antigen-binding domains (D1 and D2). Asused herein, the expression “antigen-binding domain” means any peptide,polypeptide, nucleic acid molecule, scaffold-type molecule, peptidedisplay molecule, or polypeptide-containing construct that is capable ofspecifically binding a particular antigen of interest. The term“specifically binds” or the like, as used herein, means that theantigen-binding domain forms a complex with a particular antigencharacterized by a dissociation constant (K_(D)) of 500 μM or less, anddoes not bind other unrelated antigens under ordinary test conditions.“Unrelated antigens” are proteins, peptides or polypeptides that haveless than 95% amino acid identity to one another.

Exemplary categories of antigen-binding domains that can be used in thecontext of the present invention include antibodies, antigen-bindingportions of antibodies, peptides that specifically interact with aparticular antigen (e.g., peptibodies), receptor molecules thatspecifically interact with a particular antigen, proteins comprising aligand-binding portion of a receptor that specifically binds aparticular antigen, antigen-binding scaffolds (e.g., DARPins, HEATrepeat proteins, ARM repeat proteins, tetratricopeptide repeat proteins,and other scaffolds based on naturally occurring repeat proteins, etc.,[see, e.g., Boersma and Pluckthun, 2011, Curr. Opin. Biotechnol.22:849-857, and references cited therein]), and aptamers or portionsthereof.

In certain embodiments in which the target molecule or the internalizingeffector protein is a receptor molecule, an “antigen-binding domain,”for purposes of the present invention, may comprise or consist of aligand or portion of a ligand that is specific for the receptor. Forexample, if the target molecule (T) is IL-4R, the D1 component of themultispecific antigen-binding molecule may comprise the IL-4 ligand or aportion of the IL-4 ligand that is capable of specifically interactingwith IL-4R; or if the internalizing effector protein (E) is transferrinreceptor, the D2 component of the multispecific antigen-binding moleculemay comprise transferrin or a portion of transferrin that is capable ofspecifically interacting with the transferrin receptor.

In certain embodiments in which the target molecule or the internalizingeffector protein is a ligand that is specifically recognized by aparticular receptor (e.g., a soluble target molecule), an“antigen-binding domain,” for purposes of the present invention, maycomprise or consist of the receptor or a ligand-binding portion of thereceptor. For example, if the target molecule (T) is IL-6, the D1component of the multispecific antigen-binding molecule may comprise theligand-binding domain of the IL-6 receptor; or if the internalizingeffector protein (E) is an indirectly internalized protein (as that termis defined elsewhere herein), the D2 component of the multispecificantigen-binding molecule may comprise a ligand-binding domain of areceptor specific for E.

Methods for determining whether two molecules specifically bind oneanother are well known in the art and include, for example, equilibriumdialysis, surface plasmon resonance, and the like. For example, anantigen-binding domain, as used in the context of the present invention,includes polypeptides that bind a particular antigen (e.g., a targetmolecule [T] or an internalizing effector protein [E]) or a portionthereof with a K_(D) of less than about 500 pM, less than about 400 pM,less than about 300 pM, less than about 200 pM, less than about 100 pM,less than about 90 pM, less than about 80 pM, less than about 70 pM,less than about 60 pM, less than about 50 pM, less than about 40 pM,less than about 30 pM, less than about 20 pM, less than about 10 pM,less than about 5 pM, less than about 4 pM, less than about 2 pM, lessthan about 1 pM, less than about 0.5 pM, less than about 0.2 pM, lessthan about 0.1 pM, or less than about 0.05 pM, as measured in a surfaceplasmon resonance assay.

The term “surface plasmon resonance”, as used herein, refers to anoptical phenomenon that allows for the analysis of real-timeinteractions by detection of alterations in protein concentrationswithin a biosensor matrix, for example using the BIAcore™ system(Biacore Life Sciences division of GE Healthcare, Piscataway, N.J.).

The term “K_(D)”, as used herein, means the equilibrium dissociationconstant of a particular protein-protein interaction (e.g.,antibody-antigen interaction). Unless indicated otherwise, the K_(D)values disclosed herein refer to K_(D) values determined by surfaceplasmon resonance assay at 25° C.

Antibodies and Antigen-Binding Fragments of Antibodies

As indicated above, an “antigen-binding domain” (D1 and/or D2) cancomprise or consist of an antibody or antigen-binding fragment of anantibody. The term “antibody,” as used herein, means any antigen-bindingmolecule or molecular complex comprising at least one complementaritydetermining region (CDR) that specifically binds to or interacts with aparticular antigen (e.g., T or E). The term “antibody” includesimmunoglobulin molecules comprising four polypeptide chains, two heavy(H) chains and two light (L) chains inter-connected by disulfide bonds,as well as multimers thereof (e.g., IgM). Each heavy chain comprises aheavy chain variable region (abbreviated herein as HCVR or V_(H)) and aheavy chain constant region. The heavy chain constant region comprisesthree domains, C_(H)1, C_(H)2 and C_(H)3. Each light chain comprises alight chain variable region (abbreviated herein as LCVR or V_(L)) and alight chain constant region. The light chain constant region comprisesone domain (C_(L)1). The V_(H) and V_(L) regions can be furthersubdivided into regions of hypervariability, termed complementaritydetermining regions (CDRs), interspersed with regions that are moreconserved, termed framework regions (FR). Each V_(H) and V_(L) iscomposed of three CDRs and four FRs, arranged from amino-terminus tocarboxy-terminus in the following order: FR1, CDR1, FR2, CDR2, FR3,CDR3, FR4. In different embodiments of the invention, the FRs of theantibodies of the invention (or antigen-binding portion thereof) may beidentical to the human germline sequences, or may be naturally orartificially modified. An amino acid consensus sequence may be definedbased on a side-by-side analysis of two or more CDRs.

The D1 and/or D2 components of the multispecific antigen-bindingmolecules of the present invention may comprise or consist ofantigen-binding fragments of full antibody molecules. The terms“antigen-binding portion” of an antibody, “antigen-binding fragment” ofan antibody, and the like, as used herein, include any naturallyoccurring, enzymatically obtainable, synthetic, or geneticallyengineered polypeptide or glycoprotein that specifically binds anantigen to form a complex. Antigen-binding fragments of an antibody maybe derived, e.g., from full antibody molecules using any suitablestandard techniques such as proteolytic digestion or recombinant geneticengineering techniques involving the manipulation and expression of DNAencoding antibody variable and optionally constant domains. Such DNA isknown and/or is readily available from, e.g., commercial sources, DNAlibraries (including, e.g., phage-antibody libraries), or can besynthesized. The DNA may be sequenced and manipulated chemically or byusing molecular biology techniques, for example, to arrange one or morevariable and/or constant domains into a suitable configuration, or tointroduce codons, create cysteine residues, modify, add or delete aminoacids, etc.

Non-limiting examples of antigen-binding fragments include: (i) Fabfragments; (ii) F(ab′)2 fragments; (iii) Fd fragments; (iv) Fvfragments; (v) single-chain Fv (scFv) molecules; (vi) dAb fragments; and(vii) minimal recognition units consisting of the amino acid residuesthat mimic the hypervariable region of an antibody (e.g., an isolatedcomplementarity determining region (CDR) such as a CDR3 peptide), or aconstrained FR3-CDR3-FR4 peptide. Other engineered molecules, such asdomain-specific antibodies, single domain antibodies, domain-deletedantibodies, chimeric antibodies, CDR-grafted antibodies, diabodies,triabodies, tetrabodies, minibodies, nanobodies (e.g. monovalentnanobodies, bivalent nanobodies, etc.), small modularimmunopharmaceuticals (SMIPs), and shark variable IgNAR domains, arealso encompassed within the expression “antigen-binding fragment,” asused herein.

An antigen-binding fragment of an antibody will typically comprise atleast one variable domain. The variable domain may be of any size oramino acid composition and will generally comprise at least one CDRwhich is adjacent to or in frame with one or more framework sequences.In antigen-binding fragments having a V_(H) domain associated with aV_(L) domain, the V_(H) and V_(L) domains may be situated relative toone another in any suitable arrangement. For example, the variableregion may be dimeric and contain V_(H)-V_(H), V_(H)-V_(L) orV_(L)-V_(L) dimers. Alternatively, the antigen-binding fragment of anantibody may contain a monomeric V_(H) or V_(L) domain.

In certain embodiments, an antigen-binding fragment of an antibody maycontain at least one variable domain covalently linked to at least oneconstant domain. Non-limiting, exemplary configurations of variable andconstant domains that may be found within an antigen-binding fragment ofan antibody of the present invention include: (i) V_(H)-C_(H)1; (ii)V_(H)-C_(H)2; (iii) V_(H)-C_(H)3; (iv) V_(H)-C_(H)1-C_(H)2; (V)V_(H)-C_(H)1-C_(H)2-C_(H)3; (vi) V_(H)-C_(H)2-C_(H)3; (vii) V_(H)-C_(L);(viii) V_(L)-C_(H)1; (ix) V_(L)-C_(H)2; (x) V_(L)-C_(H)3; (xi)V_(L)-C_(H)1-C_(H)2; (xii) V_(L)-C_(H)1-C_(H)2-C_(H)3; (xiii)V_(L)-C_(H)2-C_(H)3; and (xiv) V_(L)-C_(L). In any configuration ofvariable and constant domains, including any of the exemplaryconfigurations listed above, the variable and constant domains may beeither directly linked to one another or may be linked by a full orpartial hinge or linker region. A hinge region may consist of at least 2(e.g., 5, 10, 15, 20, 40, 60 or more) amino acids which result in aflexible or semi-flexible linkage between adjacent variable and/orconstant domains in a single polypeptide molecule. Moreover, anantigen-binding fragment may comprise a homo-dimer or hetero-dimer (orother multimer) of any of the variable and constant domainconfigurations listed above in non-covalent association with one anotherand/or with one or more monomeric V_(H) or V_(L) domain (e.g., bydisulfide bond(s)).

The multispecific antigen-binding molecules of the present invention maycomprise or consist of human antibodies and/or recombinant humanantibodies, or fragments thereof. The term “human antibody”, as usedherein, includes antibodies having variable and constant regions derivedfrom human germline immunoglobulin sequences. Human antibodies maynonetheless include amino acid residues not encoded by human germlineimmunoglobulin sequences (e.g., mutations introduced by random orsite-specific mutagenesis in vitro or by somatic mutation in vivo), forexample in the CDRs and in particular CDR3. However, the term “humanantibody”, as used herein, is not intended to include antibodies inwhich CDR sequences derived from the germline of another mammalianspecies, such as a mouse, have been grafted onto human frameworksequences.

The multispecific antigen-binding molecules of the present invention maycomprise or consist of recombinant human antibodies or antigen-bindingfragments thereof. The term “recombinant human antibody”, as usedherein, is intended to include all human antibodies that are prepared,expressed, created or isolated by recombinant means, such as antibodiesexpressed using a recombinant expression vector transfected into a hostcell (described further below), antibodies isolated from a recombinant,combinatorial human antibody library (described further below),antibodies isolated from an animal (e.g., a mouse) that is transgenicfor human immunoglobulin genes (see e.g., Taylor et al. (1992) Nucl.Acids Res. 20:6287-6295) or antibodies prepared, expressed, created orisolated by any other means that involves splicing of humanimmunoglobulin gene sequences to other DNA sequences. Such recombinanthuman antibodies have variable and constant regions derived from humangermline immunoglobulin sequences. In certain embodiments, however, suchrecombinant human antibodies are subjected to in vitro mutagenesis (or,when an animal transgenic for human Ig sequences is used, in vivosomatic mutagenesis) and thus the amino acid sequences of the V_(H) andV_(L) regions of the recombinant antibodies are sequences that, whilederived from and related to human germline V_(H) and V_(L) sequences,may not naturally exist within the human antibody germline repertoire invivo.

Bispecific Antibodies

According to certain embodiments, the multispecific antigen-bindingmolecules of the invention are bispecific antibodies; e.g., bispecificantibodies comprising an antigen-binding arm that specifically binds atarget molecule (T) and an antigen-binding arm that specifically bindsan internalizing effector protein (E). Methods for making bispecificantibodies are known in the art and may be used to constructmultispecific antigen-binding molecules of the present invention.Exemplary bispecific formats that can be used in the context of thepresent invention include, without limitation, e.g., scFv-based ordiabody bispecific formats, IgG-scFv fusions, dual variable domain(DVD)-Ig, Quadroma, knobs-into-holes, common light chain (e.g., commonlight chain with knobs-into-holes, etc.), CrossMab, CrossFab,(SEED)body, leucine zipper, Duobody, IgG1/IgG2, dual acting Fab(DAF)-IgG, and Mab² bispecific formats (see, e.g., Klein et al. 2012,mAbs 4:6, 1-11, and references cited therein, for a review of theforegoing formats).

Multimerizing Components

The multispecific antigen-binding molecules of the present invention, incertain embodiments, may also comprise one or more multimerizingcomponent(s). The multimerizing components can function to maintain theassociation between the antigen-binding domains (D1 and D2). As usedherein, a “multimerizing component” is any macromolecule, protein,polypeptide, peptide, or amino acid that has the ability to associatewith a second multimerizing component of the same or similar structureor constitution. For example, a multimerizing component may be apolypeptide comprising an immunoglobulin C_(H)3 domain. A non-limitingexample of a multimerizing component is an Fc portion of animmunoglobulin, e.g., an Fc domain of an IgG selected from the isotypesIgG1, IgG2, IgG3, and IgG4, as well as any allotype within each isotypegroup. In certain embodiments, the multimerizing component is an Fcfragment or an amino acid sequence of 1 to about 200 amino acids inlength containing at least one cysteine residues. In other embodiments,the multimerizing component is a cysteine residue, or a shortcysteine-containing peptide. Other multimerizing domains includepeptides or polypeptides comprising or consisting of a leucine zipper, ahelix-loop motif, or a coiled-coil motif.

In certain embodiments, the multispecific antigen-binding molecules ofthe present invention comprise two multimerizing domains, M1 and M2,wherein D1 is attached to M1 and D2 is attached to M2, and wherein theassociation of M1 with M2 facilitates the physical linkage of D1 and D2to one another in a single multispecific antigen-binding molecule. Incertain embodiments, M1 and M2 are identical to one another. Forexample, M1 can be an Fc domain having a particular amino acid sequence,and M2 is an Fc domain with the same amino acid sequence as M1.Alternatively, M1 and M2 may differ from one another at one or moreamino acid position. For example, M1 may comprise a first immunoglobulin(Ig) C_(H)3 domain and M2 may comprise a second Ig C_(H)3 domain,wherein the first and second Ig C_(H)3 domains differ from one anotherby at least one amino acid, and wherein at least one amino aciddifference reduces binding of the targeting construct to Protein A ascompared to a reference construct having identical M1 and M2 sequences.In one embodiment, the Ig C_(H)3 domain of M1 binds Protein A and the IgC_(H)3 domain of M2 contains a mutation that reduces or abolishesProtein A binding such as an H95R modification (by IMGT exon numbering;H435R by EU numbering). The C_(H)3 of M2 may further comprise a Y96Fmodification (by IMGT; Y436F by EU). Further modifications that may befound within the C_(H)3 of M2 include: D16E, L18M, N44S, K52N, V57M, andV821 (by IMGT; D356E, L358M, N384S, K392N, V397M, and V422I by EU) inthe case of an IgG1 Fc domain; N44S, K52N, and V821 (IMGT; N384S, K392N,and V422I by EU) in the case of an IgG2 Fc domain; and Q15R, N44S, K52N,V57M, R69K, E79Q, and V821 (by IMGT; Q355R, N384S, K392N, V397M, R409K,E419Q, and V422I by EU) in the case of an IgG4 Fc domain.

Internalizing Effector Proteins (E)

In the context of the present invention, the D2 component of themultispecific antigen-binding molecule specifically binds aninternalizing effector protein (“E”). An internalizing effector proteinis a protein that is capable of being internalized into a cell or thatotherwise participates in or contributes to retrograde membranetrafficking. In some instances, the internalizing effector protein is aprotein that undergoes transcytosis; that is, the protein isinternalized on one side of a cell and transported to the other side ofthe cell (e.g., apical-to-basal). In many embodiments, the internalizingeffector protein is a cell surface-expressed protein or a solubleextracellular protein. However, the present invention also contemplatesembodiments in which the internalizing effector protein is expressedwithin an intracellular compartment such as the endosome, endoplasmicreticulum, Golgi, lysosome, etc. For example, proteins involved inretrograde membrane trafficking (e.g., pathways from early/recyclingendosomes to the trans-Golgi network) may serve as internalizingeffector proteins in various embodiments of the present invention. Inany event, the binding of D2 to an internalizing effector protein causesthe entire multispecific antigen-binding molecule, and any moleculesassociated therewith (e.g., a target molecule bound by D1), to alsobecome internalized into the cell. As explained below, internalizingeffector proteins include proteins that are directly internalized into acell, as well as proteins that are indirectly internalized into a cell.

Internalizing effector proteins that are directly internalized into acell include membrane-associated molecules with at least oneextracellular domain (e.g., transmembrane proteins, GPI-anchoredproteins, etc.), which undergo cellular internalization, and arepreferably processed via an intracellular degradative and/or recyclingpathway. Specific non-limiting examples of internalizing effectorproteins that are directly internalized into a cell include, e.g., CD63,MHC-I (e.g., HLA-B27), Kremen-1, Kremen-2, LRP5, LRP6, LRP8, transferrinreceptor, LDL-receptor, LDL-related protein 1 receptor, ASGR1, ASGR2,amyloid precursor protein-like protein-2 (APLP2), apelin receptor(APLNR), MAL (Myelin And Lymphocyte protein, a.k.a. VIP17), IGF2R,vacuolar-type H⁺ ATPase, diphtheria toxin receptor, folate receptor,glutamate receptors, glutathione receptor, leptin receptors, scavengerreceptors (e.g., SCARA1-5, SCARB1-3, CD36), etc.

In embodiments in which E is a directly internalized effector protein,the D2 component of the multispecific antigen-binding molecule can be,e.g., an antibody or antigen-binding fragment of an antibody thatspecifically binds E, or a ligand or portion of a ligand thatspecifically interacts with the effector protein. For example, if E isKremen-1 or Kremen-2, the D2 component can comprise or consist of aKremen ligand (e.g., DKK1) or Kremen-binding portion thereof. As anotherexample, if E is a receptor molecule such as ASGR1, the D2 component cancomprise or consist of a ligand specific for the receptor (e.g.,asialoorosomucoid [ASOR] or Beta-GalNAc) or a receptor-binding portionthereof.

Internalizing effector proteins that are indirectly internalized into acell include proteins and polypeptides that do not internalize on theirown, but become internalized into a cell after binding to or otherwiseassociating with a second protein or polypeptide that is directlyinternalized into the cell. Proteins that are indirectly internalizedinto a cell include, e.g., soluble ligands that are capable of bindingto an internalizing cell surface-expressed receptor molecule. Anon-limiting example of a soluble ligand that is (indirectly)internalized into a cell via its interaction with an internalizing cellsurface-expressed receptor molecule is transferrin. In embodimentswherein E is transferrin (or another indirectly internalized protein),the binding of D2 to E, and the interaction of E with transferrinreceptor (or another internalizing cell-surface expressed receptormolecule), causes the entire multispecific antigen-binding molecule, andany molecules associated therewith (e.g., a target molecule bound byD1), to become internalized into the cell concurrent with theinternalization of E and its binding partner.

In embodiments in which E is an indirectly internalized effector proteinsuch as a soluble ligand, the D2 component of the multispecificantigen-binding molecule can be, e.g., an antibody or antigen-bindingfragment of an antibody that specifically binds E, or a receptor orportion of a receptor that specifically interacts with the solubleeffector protein. For example, if E is a cytokine, the D2 component cancomprise or consist of the corresponding cytokine receptor orligand-binding portion thereof.

Target Molecules (T)

In the context of the present invention, the D1 component of themultispecific antigen-binding molecule specifically binds a targetmolecule (“T”). A target molecule is any protein, polypeptide, or othermacromolecule whose activity or extracellular concentration is desiredto be attenuated, reduced or eliminated. In many instances, the targetmolecule to which D1 binds is a protein or polypeptide [i.e., a “targetprotein”]; however, the present invention also includes embodimentswherein the target molecule (“T”) is a carbohydrate, glycoprotein,lipid, lipoprotein, lipopolysaccharide, or other non-protein polymer ormolecule to which D1 binds. According to the present invention, T can bea cell surface-expressed target protein or a soluble target protein.Target binding by the multispecific antigen-binding molecule may takeplace in an extracellular or cell surface context. In certainembodiments, however, the multispecific antigen-binding molecule binds atarget molecule inside the cell, for example within an intracellularcomponent such as the endoplasmic reticulum, Golgi, endosome, lysosome,etc.

Examples of cell surface-expressed target molecules include cellsurface-expressed receptors, membrane-bound ligands, ion channels, andany other monomeric or multimeric polypeptide component with anextracellular portion that is attached to or associated with a cellmembrane. Non-limiting, exemplary cell surface-expressed targetmolecules that may be targeted by the multispecific antigen-bindingmolecule of the present invention include, e.g., cytokine receptors(e.g., receptors for IL-1, IL-4, IL-6, IL-13, IL-22, IL-25, IL-33,etc.), as well as cell surface targets including other type 1transmembrane receptors such as PRLR, G-protein coupled receptors suchas GCGR, ion channels such as Nav1.7, ASIC1 or ASIC2, non-receptorsurface proteins such as MHC-I (e.g., HLA-B*27), etc.

In embodiments in which T is a cell surface-expressed target protein,the D1 component of the multispecific antigen-binding molecule can be,e.g., an antibody or antigen-binding fragment of an antibody thatspecifically binds T, or a ligand or portion of a ligand thatspecifically interacts with the cell surface-expressed target protein.For example, if T is IL-4R, the D1 component can comprise or consist ofIL-4 or a receptor-binding portion thereof.

Examples of soluble target molecules include cytokines, growth factors,and other ligands and signaling proteins. Non-limiting exemplary solubletarget protein that may be targeted by the multispecific antigen-bindingmolecule of the present invention include, e.g., IL-1, IL-4, IL-6,IL-13, IL-22, IL-25, IL-33, SOST, DKK1, etc. Soluble targets moleculesalso include, e.g., non-human target molecules such as allergens (e.g.,Fel D1, Betv1, CryJ1), pathogens (e.g., Candida albicans, S. aureus,etc.), and pathogenic molecules (e.g., lipopolysaccharide [LPS],lipotechoic acid [LTA], Protein A., toxins, etc.). In embodiments inwhich T is a soluble target molecule, the D1 component of themultispecific antigen-binding molecule can be, e.g., an antibody orantigen-binding fragment of an antibody that specifically binds T, or areceptor or portion of a receptor that specifically interacts with thesoluble target molecule. For example, if T is IL-4, the D1 component cancomprise or consist of IL-4R or a ligand-binding portion thereof.

Target molecules also include tumor-associated antigens, as describedelsewhere herein.

pH-Dependent Binding

The present invention provides multispecific antigen-binding moleculescomprising a first antigen-binding domain (D1) and a secondantigen-binding domain (D2), wherein one or both of the antigen-bindingdomains (D1 and/or D2) binds its antigen (T or E) in a pH-dependentmanner. For example, an antigen-binding domain (D1 and/or D2) mayexhibit reduced binding to its antigen at acidic pH as compared toneutral pH. Alternatively, an antigen-binding domain (D1 and/or D2) mayexhibit enhanced binding to its antigen at acidic pH as compared toneutral pH. Antigen-binding domains with pH-dependent bindingcharacteristics may be obtained, e.g., by screening a population ofantibodies for reduced (or enhanced) binding to a particular antigen atacidic pH as compared to neutral pH. Additionally, modifications of theantigen-binding domain at the amino acid level may yield antigen-bindingdomains with pH-dependent characteristics. For example, by substitutingone or more amino acid of an antigen-binding domain (e.g., within a CDR)with a histidine residue, an antigen-binding domain with reducedantigen-binding at acidic pH relative to neutral pH may be obtained.

In certain embodiments, the present invention includes multispecificantigen-binding molecules comprising a D1 and/or D2 component that bindsits respective antigen (T or E) at acidic pH with a K_(D) that is atleast about 3, 5, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 25, 30,35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95, 100, or more timesgreater than the K_(D) of the D1 and/or D2 component for binding to itsrespective antigen at neutral pH. pH dependent binding may also beexpressed in terms of the t½ of the antigen-binding domain for itsantigen at acidic pH compared to neutral pH. For example, the presentinvention includes multispecific antigen-binding molecules comprising aD1 and/or D2 component that binds its respective antigen (T or E) atacidic pH with a t½ that is at least about 5, 6, 7, 8, 9, 10, 15, 20,25, 30, 35, 40, 45, 50, 55, 60, or more times shorter than the t½ of theD1 and/or D2 component for binding to its respective antigen at neutralpH.

Multispecific antigen-binding molecules of the present invention thatcomprise a D1 and/or D2 component with reduced antigen binding at acidicpH as compared to neutral pH, when administered to animal subjects, mayin certain embodiments exhibit slower clearance from circulation ascompared to comparable molecules that do not exhibit pH-dependentbinding characteristics. According to this aspect of the invention,multispecific antigen-binding molecules with reduced antigen binding toeither T and/or E at acidic pH as compared to neutral pH are providedwhich exhibit at least 2 times slower clearance from circulationrelative to comparable antigen-binding molecules that do not possessreduced antigen binding at acidic pH as compared to neutral pH.Clearance rate can be expressed in terms of the half-life of theantibody, wherein a slower clearance correlates with a longer half-life.

As used herein, the expression “acidic pH” means a pH of 6.0 or less.The expression “acidic pH” includes pH values of about 6.0, 5.95, 5.8,5.75, 5.7, 5.65, 5.6, 5.55, 5.5, 5.45, 5.4, 5.35, 5.3, 5.25, 5.2, 5.15,5.1, 5.05, 5.0, or less. As used herein, the expression “neutral pH”means a pH of about 7.0 to about 7.4. The expression “neutral pH”includes pH values of about 7.0, 7.05, 7.1, 7.15, 7.2, 7.25, 7.3, 7.35,and 7.4.

Attenuation of Target Molecule Activity

As noted elsewhere herein, and as demonstrated by the working Examplesherein below, the present inventors have discovered that thesimultaneous binding of a target molecule (T) and an internalizingeffector protein (E) by a multispecific antigen-binding moleculeattenuates the activity of T to a greater extent than the binding of Tby the first antigen-binding domain (D1) component of the multispecificantigen-binding molecule alone. As used herein, the expression“attenuates the activity of T to a greater extent than the binding of Tby D1 alone” means that, in an assay in which the activity of T can bemeasured using cells that express E, the level of T activity measured inthe presence of a multispecific antigen-binding molecule is at least 10%lower than the level of T activity measured in the presence of a controlconstruct containing D1 by itself (i.e., not physically linked to thesecond antigen-binding domain (D2)). For instance, the level of Tactivity measured in the presence of the multispecific antigen-bindingmolecule may be about 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%,60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, or 100% lower than the level ofT activity measured in the presence of a control construct containing D1by itself.

A non-limiting, illustrative assay format for determining whether amultispecific antigen-binding molecule attenuates the activity of atarget molecule to a greater extent than the binding of the targetmolecule by the D1 domain alone is shown in working Examples 1 and 2,herein below. In Example 1, for instance, “T” is the interleukin-4receptor (IL-4R), and “E” is CD63. The multispecific antigen-bindingmolecule of Example 1 is a 2-antibody conjugate comprising an anti-IL-4RmAb linked to an anti-CD63 mAb via a streptavidin/biotin linker. Thus,“D1” in this exemplary construct is the antigen-binding domain(HCVR/LCVR pair) of the anti-IL-4R antibody, and “D2” is theantigen-binding domain (HCVR/LCVR pair) of the anti-CD63 antibody. Forthe experiments of Examples 1 and 2, a cell-based assay format was usedthat produces a reporter signal when IL-4R activity is stimulated by theaddition of exogenous IL-4 ligand. The amount of IL-4-induced reporteractivity detected in the presence of the multispecific antigen-bindingmolecule was compared to the amount of IL-4-induced reporter activitydetected in the presence of control constructs containing the anti-IL-4Rantibody either connected to an irrelevant control immunoglobulin(control 1), or combined with, but not physically connected to, theanti-CD63 antibody (control 2). The control constructs thus produce thecondition in which T is bound by D1 alone (i.e., wherein D1 is not apart of the multispecific antigen-binding molecule per se). If theextent of target molecule activity (represented by the reporter signal)observed in the presence of the multispecific antigen-binding moleculeis at least 10% less than the amount of target molecule activityobserved in the presence of a control construct comprising the D1component not physically linked to the D2 component (e.g., control 1 orcontrol 2), then for purposes of the present disclosure, it is concludedthat “the simultaneous binding of T and E by the multispecificantigen-binding molecule attenuates the activity of T to a greaterextent than the binding of T by D1 alone.”

The binding of T by D1 alone may, in some embodiments, result in partialattenuation of the activity of T (as in the case of Example 1 where thetreatment of reporter cells with an anti-IL-4R antibody alone [i.e.,controls 1 and 2] caused a small level of attenuation of IL-4 signalingrelative to untreated cells). In other embodiments, the binding of T byD1 alone will result in no detectable attenuation of the activity of T;that is, the biological activity of T may be unaffected by the bindingof T by D1 alone. In any event, however, the simultaneous binding of Tand E by a multispecific antigen-binding molecule of the invention willattenuate the activity of T to a greater extent than the binding of T byD1 alone.

Alternative assay formats and variations on the assay format(s)exemplified herein will be apparent to persons of ordinary skill in theart, taking into account the nature of the specific target molecule andeffector proteins to which any given multispecific antigen-bindingmolecule may be directed. Any such format can be used in the context ofthe present invention to determine whether the simultaneous binding of Tand E by a multispecific antigen-binding molecule attenuates theactivity of T to a greater extent than the binding of T by D1 alone.

Tumor Targeting

In another aspect of the invention, the multispecific antigen-bindingmolecules are useful for targeting tumor cells. According to this aspectof the invention, the target molecule “T” to which D1 binds is atumor-associated antigen. In certain instances, the tumor-associatedantigen is an antigen that is not ordinarily internalized. Theinternalizing effector protein “E” to which D2 binds may be tumorspecific, or it may be expressed on both tumor and non-tumor cells of anindividual. Any of the internalizing effector proteins mentionedelsewhere herein may be targeted for anti-tumor applications of theinvention.

As used herein, the term “tumor-associated antigen” includes proteins orpolypeptides that are preferentially expressed on the surface of a tumorcell. The expression “preferentially expressed,” as used in thiscontext, means that the antigen is expressed on a tumor cell at a levelthat is at least 10% greater (e.g., 10%, 20%, 30%, 40%, 50%, 60%, 70%,80%, 90%, 100%, 110%, 150%, 200%, 400%, or more) than the expressionlevel of the antigen on non-tumor cells. In certain embodiments, thetarget molecule is an antigen that is preferentially expressed on thesurface of a tumor cell selected from the group consisting of a renaltumor cell, a colon tumor cell, a breast tumor cell, an ovarian tumorcell, a skin tumor cell, a lung tumor cell, a prostate tumor cell, apancreatic tumor cell, a glioblastoma cell, a head and neck tumor celland a melanoma cell. Non-limiting examples of specific tumor-associatedantigens include, e.g., AFP, ALK, BAGE proteins, β-catenin, brc-abl,BRCA1, BORIS, CA9, carbonic anhydrase IX, caspase-8, CD40, CDK4, CEA,CTLA4, cyclin-B1, CYP1B1, EGFR, EGFRvIII, ErbB2/Her2, ErbB3, ErbB4,ETV6-AML, EphA2, Fra-1, FOLR1, GAGE proteins (e.g., GAGE-1, -2), GD2,GD3, GloboH, glypican-3, GM3, gp100, Her2, HLA/B-raf, HLA/k-ras,HLA/MAGE-A3, hTERT, LMP2, MAGE proteins (e.g., MAGE-1, -2, -3, -4, -6,and -12), MART-1, mesothelin, ML-IAP, Muc1, Muc16 (CA-125), MUM1, NA17,NY-BR1, NY-BR62, NY-BR85, NY-ES01, OX40, p15, p53, PAP, PAX3, PAX5,PCTA-1, PLAC1, PRLR, PRAME, PSMA (FOLH1), RAGE proteins, Ras, RGS5, Rho,SART-1, SART-3, Steap-1, Steap-2, survivin, TAG-72, TGF-β, TMPRSS2, Tn,TRP-1, TRP-2, tyrosinase, and uroplakin-3.

The multispecific antigen-binding molecule, according to this aspect ofthe invention, may be conjugated to a drug, toxin, radioisotope, orother substance which is detrimental to the viability of a cell.Alternatively, the drug or toxin may be a substance which does notdirectly kill a cell, but renders a cell more susceptible to killing byother external agents. In yet other embodiments involving tumortargeting, the multispecific antigen-binding molecule of the inventionis not itself conjugated to a drug, toxin or radioisotope, but insteadis administered in combination with a second antigen-binding moleculespecific for the target (T) (herein referred to as an “accomplicemolecule”), wherein the accomplice molecule is conjugated to a drug,toxin or radioisotope. In such embodiments, the multispecific antigenbinding molecule will preferably bind to an epitope on the targetmolecule (T) that is distinct from and/or non-overlapping with theepitope recognized by the accomplice molecule (i.e., to allow forsimultaneous binding of the multispecific antigen-binding molecule andthe accomplice molecule to the target).

In a related embodiment, the present invention also includes anti-tumorcombinations, and therapeutic methods, comprising: (a) a toxin- ordrug-conjugated antigen-binding molecule that specifically binds atumor-associated antigen; and (b) a multispecific antigen-bindingmolecule comprising (i) a first binding domain that specifically bindsan internalizing effector protein (e.g., with low affinity) and (ii) asecond binding domain that specifically binds the toxin- ordrug-conjugated antigen-binding molecule. In this embodiment, themultispecific antigen-binding molecule functions to link the toxin- ordrug-conjugated antigen-binding molecule to the internalizing effectorprotein, which thereby functions to physically link the tumor associatedantigen to the internalizing effector protein. Internalization of thetoxin-labeled anti-tumor-associated antigen antibody via its connectionto the internalizing effector protein would consequently result intargeted tumor cell killing.

According to certain embodiments of the tumor-targeting aspects of theinvention, the multispecific antigen-binding molecule (or accompliceantibody) may be conjugated to one or more cytotoxic drugs selected fromthe group consisting of: calicheamicin, esperamicin, methotrexate,doxorubicin, melphalan, chlorambucil, ARA-C, vindesine, mitomycin C,cis-platinum, etoposide, bleomycin, 5-fluorouracil, estramustine,vincristine, etoposide, doxorubicin, paclitaxel, larotaxel, tesetaxel,orataxel, docetaxel, dolastatin 10, auristatin E, auristatin PHE andmaytansine-based compounds (e.g., DM1, DM4, etc.). The multispecificantigen-binding molecule (or accomplice antibody) may also, oralternatively, be conjugated to a toxin such as diphtheria toxin,Pseudomonas aeruginosa exotoxin A, ricin A chain, abrin A chain,modeccin A chain, alpha-sarcin, Aleurites fordii proteins, dianthinproteins, Phytolaca americana proteins, etc. The multispecificantigen-binding molecule (or accomplice antibody) may also, oralternatively, be conjugated to one or more radioisotope selected fromthe group consisting of ²²⁵Ac, ²¹¹At, ²¹²Bi, ²¹³Bi, ¹⁸⁶Rh, ¹⁸⁸Rh, ¹⁷⁷Lu,⁸⁰Y, ¹³¹I, ⁶⁷Cu, ¹²⁵I, ¹²³I, ⁷⁷Br, ¹⁵³Sm, ¹⁶⁶Ho, ⁶⁴Cu, ¹²¹Pb, ²²⁴Ra and²²³Ra. Thus, this aspect of the invention includes multispecificantigen-binding molecules that are antibody-drug conjugates (ADCs) orantibody-radioisotope conjugates (ARCs).

In the context of tumor killing applications, the D2 component may, incertain circumstances, bind with low affinity to the internalizingeffector protein “E”. Thus, the multispecific antigen-binding moleculewill preferentially target tumor cells that express the tumor-associatedantigen. As used herein, “low affinity” binding means that the bindingaffinity of the D2 component for the internalizing effector protein (E)is at least 10% weaker (e.g., 15% weaker, 25% weaker, 50% weaker, 75%weaker, 90% weaker, etc.) than the binding affinity of the D1 componentfor the target molecule (T). In certain embodiments, “low affinity”binding means that the D2 component interacts with the internalizingeffector protein (E) with a K_(D) of greater than about 10 nM to about 1μM, as measured in a surface plasmon resonance assay at about 25° C.

The simultaneous binding of a multispecific antigen-binding molecule toan internalizing effector protein and a tumor-associated antigen willresult in preferential internalization of the multispecificantigen-binding molecule into tumor cells. If, for example, themultispecific antigen-binding molecule is conjugated to a drug, toxin orradioisotope (or if the multispecific antigen-binding molecule isadministered in combination with an accomplice antibody that isconjugated to a drug, toxin or radioisotope), the targetedinternalization of the tumor-associated antigen into the tumor cell viaits linkage to the multispecific antigen-binding molecule, will resultin extremely specific tumor cell killing.

Pharmaceutical Compositions and Administration Methods

The present invention includes pharmaceutical compositions comprising amultispecific antigen-binding molecule. The pharmaceutical compositionsof the invention can be formulated with suitable carriers, excipients,and other agents that provide improved transfer, delivery, tolerance,and the like.

The present invention also includes methods for inactivating orattenuating the activity of a target molecule (T). The methods of thepresent invention comprise contacting a target molecule with amultispecific antigen-binding molecule as described herein. In certainembodiments, the methods according to this aspect of the inventioncomprise administering a pharmaceutical composition comprising amultispecific antigen-binding molecule to a patient for whom it isdesirable and/or beneficial to inactivate, attenuate, or otherwisedecrease the extracellular concentration of a target molecule.

Various delivery systems are known in the art and can be used toadminister the pharmaceutical compositions of the present invention to apatient. Methods of administration that can be used in the context ofthe present invention include, but are not limited to, intradermal,intramuscular, intraperitoneal, intravenous, subcutaneous, intranasal,epidural, and oral routes. The pharmaceutical compositions of theinvention may be administered by any convenient route, for example byinfusion or bolus injection, by absorption through epithelial ormucocutaneous linings (e.g., oral mucosa, rectal and intestinal mucosa,etc.), and may be administered together with other biologically activeagents. Administration can be systemic or local. For example, apharmaceutical composition of the present invention can be deliveredsubcutaneously or intravenously with a standard needle and syringe. Inaddition, with respect to subcutaneous delivery, a pen delivery devicecan be used to administer a pharmaceutical composition of the presentinvention to a patient.

EXAMPLES

The following examples are put forth so as to provide those of ordinaryskill in the art with a complete disclosure and description of how tomake and use the methods and compositions of the invention, and are notintended to limit the scope of what the inventors regard as theirinvention. Efforts have been made to ensure accuracy with respect tonumbers used (e.g., amounts, temperature, etc.) but some experimentalerrors and deviations should be accounted for. Unless indicatedotherwise, parts are parts by weight, molecular weight is averagemolecular weight, temperature is in degrees Centigrade, and pressure isat or near atmospheric.

Example 1 Use of a Multispecific Antigen-Binding Molecule to InduceDegradation of a Cell Surface Receptor Via Linkage with an InternalizingEffector Protein

As an initial proof-of-concept experiment, a multispecificantigen-binding molecule was created which is capable of binding (a) aninternalizing effector molecule and (b) a cell surface receptor targetmolecule. In this Example, the internalizing effector protein isKremen-2 (Krm2), and the cell surface receptor target molecule is an Fcreceptor (FcγR1 [Fc-gamma-R1]).

Kremen molecules (Krm1 and Krm2) are cell-surface proteins known tomediate WNT signaling by directing the internalization and degradationof the WNT pathway signaling molecules LRP5 and LRP6. Internalization ofLRP5/6 is accomplished via the soluble interacting protein DKK1. Inparticular, DKK1 links Kremen to LRP5/6 on the cell surface, and becauseof this linkage, the internalization of Kremen drives theinternalization and degradation of LRP5 and LRP6. (See Li et al., PLoSOne 5(6):e11014).

The present inventors sought to exploit the Kremen-binding properties ofDKK1 and the internalization properties of Kremen to induce theinternalization of FcγR1. To facilitate Kremen-mediatedinternalization/degradation of FcγR1, a multispecific antigen-bindingmolecule was constructed consisting of DKK1 fused to a mouse Fc(DKK1-mFc, having the amino acid sequence of SEQ ID NO:1). As explainedelsewhere herein, a multispecific antigen-binding molecule is defined asa molecule comprising a first antigen-binding domain (D1) whichspecifically binds a target molecule, and a second antigen-bindingdomain (D2) which specifically binds an internalizing effector protein.In this proof-of-concept Example, the “first antigen-binding domain” isthe mFc component which specifically binds the target molecule FcγR1,and the “second antigen-binding domain” is the DKK1 component whichspecifically binds the internalizing effector protein Kremen.

An experiment was first conducted to determine whether DKK1-mFc can beendocytosed into cells in a Kremen-dependent manner. For thisexperiment, two cell lines were used: Cell-1, an HEK293 cell lineengineered to express FcγR1 but not Kremen-2, and Cell-2, an HEK293 cellline engineered to express both FcγR1 and Kremen-2. A 1:10 dilution ofDKK1-mFc conditioned medium was added to the respective cell lines andallowed to incubate at 37° C. for 90 minutes. After the 90 minuteincubation, cells were stained with Alexa-488-labeled anti-mouse IgGantibody to detect the DKK1-mFc molecule. Using fluorescence microscopy,it was observed that virtually no DKK1-mFc was localized inside Cell-1(lacking Kremen); however, substantial amounts of DKK1-mFc were detectedwithin Cell-2 which expresses Kremen-2. Thus, these results show thatthe multispecific antigen-binding molecule DKK1-mFc can be internalizedinto cells in a Kremen-dependent manner.

Next, a time-course experiment was conducted to determine whetherDKK1-mFc can induce FcγR1 degradation in a Kremen-dependent manner. Abrief description of the experimental protocol is as follows: Cell-1(expressing only FcγR1) and Cell-2 (expressing Kremen-2 and FcγR1) weretreated with 2 mg/ml NHS-Sulfo-Biotin for 15 minutes on ice to label allcell surface expressed proteins. Cells were then washed and resuspendedin 400 μl of medium and divided into four-100 μl aliquots which weretreated with DKK1-mFc for varying amounts of time (0 min, 15 min, 30 minand 60 min) at 37° C. Following DKK1-mFc incubation, cells were pelletedand treated with protease inhibitors. Lysates of the cells from thedifferent incubation time points were subjected to FcγR1immunoprecipitation. For the FcγR1 immunoprecipitation, mouse anti-FcγR1antibody was added to cell lysates and incubated for 1 hour at 4° C.Then Protein-G beads were added and the mixture was incubated for 1 hourat 4° C. The beads were then washed and the proteins eluted andsubjected to SDS-PAGE. Proteins were transferred to membrane and probedwith HRP-labeled streptavidin to reveal relative amounts of remainingsurface-exposed FcγR1 protein in each sample. Results are shown in FIG.2.

As illustrated in FIG. 2, the amount of surface-exposed FcγR1 protein inCell-1 samples (expressing FcγR1 but not Kremen-2) remained relativelyconstant regardless of the amount of time the cells were exposed toDKK1-mFc. By contrast, the amount of surface-exposed FcγR1 protein inCell-2 samples (expressing both Kremen-2 and FcγR1) decreasedsubstantially with increasing incubation times with DKK1-mFc. Thus, thisexperiment demonstrates that DKK1-mFc induces degradation of cellsurface expressed FcγR1 in a Kremen-2-dependent manner.

Taken together, the foregoing results show that a multispecificantigen-binding molecule that simultaneously binds a cell surface targetmolecule (FcγR1) and an internalizing effector protein (Kremen-2), caninduce degradation of the target molecule in an effectorprotein-dependent manner.

Example 2 IL-4R Activity is Attenuated Using a MultispecificAntigen-Binding Molecule with Specificity for IL-4R and CD63

In a further set of proof-of-concept experiments, a multispecificantigen-binding molecule was constructed which is capable ofsimultaneously binding a cell surface-expressed target molecule (i.e.,IL-4R) and a cell surface-expressed internalizing effector protein(i.e., CD63). The purpose of these experiments was to determine whetherIL-4R activity on a cell can be attenuated to a greater extent byphysically linking IL-4R to an effector molecule that is internalizedand targeted for degradation within the lysosome (in this case, CD63).In other words, this Example was designed to test whether the normalinternalization and degradation of CD63 could be used to force theinternalization and degradative rerouting of IL-4R within a cell.

First, a multispecific antigen-binding molecule was constructed that isable to bind both IL-4R and CD63. Specifically, astreptavidin-conjugated anti-IL-4R antibody and a biotinylated anti-CD63antibody were combined in a 1:1 ratio to produce an anti-IL-4R:anti-CD63conjugate (i.e., a multispecific antigen-binding molecule thatspecifically binds both IL-4R and CD63). The anti-IL-4R antibody used inthis Example is a fully human mAb raised against the IL-4R extracellulardomain. (The anti-IL-4R antibody comprised a heavy chain variable regionhaving SEQ ID NO:3 and a light chain variable region having SEQ IDNO:4). The anti-CD63 antibody used in this Example is the mouseanti-human CD63 mAb clone MEM-259, obtained from Biolegend (San Diego,Calif.), catalog. No. 312002.

Two control constructs were also created:Control-1=streptavidin-conjugated anti-IL-4R antibody combined in a 1:1ratio with biotinylated control mouse IgG1kappa antibody; andControl-2=streptavidin-conjugated anti-IL-4R antibody combined in a 1:1ratio with non-biotinylated anti-CD63 antibody. The anti-IL-4R antibodyused in the experimental and control constructs for this Example is anantibody that is known to specifically bind IL-4R and only partiallyblock IL-4-mediated signaling.

The experimental cell line used in this Example is an HEK293 cell linecontaining a STAT6-luciferase reporter construct and additional STAT6(“HEK293/STAT6-luc cells”). The cells used in this experiment expressboth IL-4R and CD63 on their surface. When treated with IL-4 in theabsence of any inhibitors, this cell line produces a dose-dependentdetectable chemiluminescence signal which reflects the extent ofIL-4-mediated signaling.

In an initial experiment, the experimental anti-IL-4R/anti-CD63multispecific molecule, or the control constructs, were added to theHEK293/STAT6-luc cells so that the final concentration of anti-IL-4Rantibody in the media was 12.5 nM. Reporter signal was measured atincreasing concentrations of IL-4 in the presence and absence of theexperimental and control constructs (FIG. 3). As seen in FIG. 3, Theanti-IL-4R/anti-CD63 multispecific molecule (“ab conjugate”) inhibitedIL-4-mediated signaling to a significantly greater extent than eithercontrol construct.

To confirm that the effect observed in FIG. 3 was dependent on CD63, thesame experiment described above was carried out, except that CD63expression was significantly reduced in the reporter cell line using ansiRNA directed against CD63. With CD63 expression significantly reduced,the enhanced inhibitory activity of the anti-IL-4R/anti-CD63multispecific molecule was no longer observed (FIG. 4). This resultsuggests that the ability of the anti-IL-4R/anti-CD63 multispecificmolecule to attenuate IL-4-mediated signaling is due to the simultaneousbinding of the multispecific molecule to IL-4R and CD63 and theconsequent internalization and degradation of the entireantibody-IL-4R-CD63 complex.

Similar experiments were next carried out in which theanti-IL-4R/anti-CD63 multispecific molecule, or the control constructs,were allowed to incubate with the HEK293/STAT6-luc reporter cell linefor various amounts of time prior to the addition of IL-4. In a firstset of such experiments, the molecules were allowed to incubate with thereporter cell line for 0 hours (i.e., added concurrently with IL-4), 2hours, or overnight prior to the addition of 50 pM IL-4. Luciferaseactivity was measured six hours after the addition of IL-4. Results areshown in FIG. 5, top panel (“untransfected”). In a further set ofexperiments, a similar protocol was carried out, except that theexperimental or control molecules were allowed to incubate with thereporter cell line for 15 minutes, 30 minutes, 1 hour or 2 hours priorto the addition of 50 pM IL-4. Results are shown in FIG. 6.

The results summarized in FIGS. 5 and 6 show that theanti-IL-4R/anti-CD63 multispecific molecule is able to inhibitIL-4-mediated signaling, and that this inhibitory effect is enhancedwith longer incubation times. As with the initial set of experiments, itwas confirmed using CD63 siRNA that the inhibitory effect of theanti-IL-4R/anti-CD63 multispecific molecule was dependent on CD63expression (FIG. 5 bottom panel [“CD63 siRNA”]).

In summary, this Example provides further proof-of-concept for theinhibition of a target molecule activity through the use of amultispecific antigen-binding molecule that is capable of simultaneouslybinding both the target molecule (in this case IL-4R) and aninternalizing effector protein (in this case CD63) to thereby cause theinternalization and degradative rerouting of the target molecule withina cell. Stated differently, the simultaneous binding of IL-4R and CD63by the exemplary multispecific antigen-binding molecule attenuated theactivity of IL-4R to a substantially greater extent (i.e., >10%) thanthe binding of IL-4R by the control constructs alone.

Example 3 An Anti-IL-4R×Anti-CD63 Bispecific Antibody Attenuates IL-4RActivity in a CD63-Dependent Manner

The experiments of Example 2, herein, show that an anti-IL-4R/anti-CD63multispecific molecule inhibits IL-4-mediated signaling in aCD63-dependent manner. In those experiments, the multispecificantigen-binding molecule consisted of two separate monoclonal antibodies(anti-IL-4R and anti-CD63) that were connected via a biotin-streptavidinlinkage. To confirm that the results observed with that proof-of-conceptmultispecific antigen-binding molecule are generalizable to othermultispecific antigen-binding molecule formats, a true bispecificantibody was constructed.

Standard bispecific antibody technology was used to construct abispecific antibody consisting of a first arm specific for IL-4R and asecond arm specific for CD63. The IL-4R-specific arm contained ananti-IL-4R heavy chain paired with a CD63-specific light chain. TheCD63-specific light chain was paired with the IL-4R specific heavy chainsolely for purposes of convenience of construction; nevertheless, thepairing of the anti-IL-4R heavy chain with the anti-CD63 light chainretained full specificity for IL-4R and did not exhibit binding to CD63.The CD63-specific arm contained an anti-CD63 heavy chain paired with ananti-CD63 light chain (the same light chain as used in the IL-4R arm).The anti-IL-4R heavy chain (comprising SEQ ID NO:3) was derived from thefull anti-IL-4R antibody as used in Example 2; However, the anti-CD63heavy and light chains were derived from the anti-CD63 antibodydesignated H5C6, obtained from the Developmental Studies Hybridoma Bank(University of Iowa Department of Biology, Iowa City, Iowa). As with thefull anti-IL-4R antibody used in Example 2, the anti-IL-4R component ofthe bispecific antibody used in this Example exhibited only moderateIL-4R blocking activity on its own.

An IL-4 luciferase assay was carried out to assess the blocking activityof the anti-IL-4R×anti-CD63 bispecific antibody. Briefly, serialdilutions of anti-IL-4R×anti-CD63 bispecific antibody or controlmolecules were added to HEK293/STAT6-luc reporter cells (see Example 2).Under normal conditions, these cells produce a detectable luciferasesignal when treated with IL-4. For this experiment, 10 pM IL-4 was thenadded to the cells, and luciferase activity was quantified for eachdilution of antibody used. The controls used in this assay were: (a)mock bispecific antibody that binds IL-4R with one arm and has anon-functional anti-CD63 arm (i.e., containing one anti-IL-4R heavychain and one anti-CD63 heavy chain, both paired with the anti-IL-4Rlight chain); (b) anti-IL-4R monospecific antibody; and (c) buffer (PBS)only (without antibody). Results are shown in FIG. 7. As shown in FIG.7, for the control samples used, luciferase activity remained relativelyhigh even at the highest antibody concentrations, whereas for thebispecific antibody, luciferase activity declined significantly asantibody concentration increased. These results confirm thatsimultaneous binding of IL-4R and CD63 by a bispecific antibody causessubstantial inhibition of IL-4R activity.

Example 4 Internalization of SOST Using a Multispecific Antigen-BindingMolecule that Simultaneously Binds SOST and CD63

In this Example, the ability of multispecific antigen-binding moleculesto promote the internalization of the soluble target molecule SOST(sclerostin) was assessed. For these experiments, the target moleculewas a fusion protein consisting of a human SOST protein tagged with apHrodo™ moiety (Life Technologies, Carlsbad, Calif.) and a myc tag. ThepHrodo™ moiety is a pH-sensitive dye that is virtually non-fluorescentat neutral pH and brightly fluorescent in an acidic environment such asthe endosome. The fluorescent signal, therefore, can be used as anindicator of cellular internalization of the SOST fusion protein. Themultispecific antigen-binding molecules for these experiments werebispecific antibodies with binding specificity for both CD63 (aninternalizing effector protein) and the SOST fusion protein (a solubletarget molecule), as described in more detail below.

The experiments were conducted as follows: Briefly, HEK293 cells wereplated at 10,000 cells/well in poly-D-lysine coated 96 well plates(Greiner Bio-One, Monroe, N.C.). After allowing the cells to settleovernight, the media was replaced with media containing antibody (5μg/mL, as described below), pHrodo™-myc-tagged-SOST (5 μg/mL), heparin(10 μg/mL), and Hoechst 33342. The cells were then incubated for either3 hours on ice or 3 hours at 37° C. All cells were washed twice prior toimaging in PBS, and the number of fluorescent spots per cell, as well asthe corresponding fluorescence intensity, was counted to establish theextent of pHrodo-myc-tagged-SOST cellular internalization in thepresence of the various antibody constructs.

The antibodies used in this Example were as follows: (1) anti-CD63monospecific antibody (clone H5C6, Developmental Studies Hybridoma Bank,University of Iowa Department of Biology, Iowa City, Iowa); (2) anti-mycantibody (clone 9E10, Schiweck et al., 1997, FEBS Lett. 414(1):33-38);(3) anti-SOST antibody (an antibody having the heavy and light chainvariable regions of the antibody designated “Ab-B” in U.S. Pat. No.7,592,429); (4) anti-CD63×anti-myc bispecific antibody (i.e., amultispecific antigen-binding molecule comprising an anti-CD63 armderived from the antibody H5C6 and an anti-myc arm derived from 9E10);(5) anti-CD63×anti-SOST bispecific antibody #1 (i.e., a multispecificantigen-binding molecule comprising an anti-CD63 arm derived from theantibody H5C6 and an anti-SOST arm derived from “Ab-B”); and (6)anti-CD63×anti-SOST bispecific antibody #2 (i.e., a multispecificantigen-binding molecule comprising an anti-CD63 arm derived from theantibody H5C6 and an anti-SOST arm derived from the antibody designated“Ab-20” in U.S. Pat. No. 7,592,429). The bispecific antibodies used inthese experiments were assembled using the so-called “knobs-into-holes”methodology (see, e.g., Ridgway et al., 1996, Protein Eng.9(7):617-621).

Results of the internalization experiments are shown in FIG. 8. FIG. 8shows the number of spots (labeled vesicles) per cell, under the varioustreatment conditions tested. Taken together, the results of theseexperiments demonstrate that the bispecific constructs, whichsimultaneously bind CD63 and SOST (either directly or via the myc tag),caused the greatest amount of SOST internalization as reflected by thefluorescence intensity and number of fluorescent spots per cell overtime at 37° C. Thus, the multispecific antigen-binding molecules used inthis Example are able to effectively direct the internalization of asoluble target molecule.

Example 5 Changes in Bone Mineral Density in Mice Treated with aMultispecific Antigen-Binding Molecule that Binds CD63 and SOST

An anti-CD63×anti-SOST multispecific antigen-binding molecule, asdescribed in Example 4, is next tested for its ability to increase bonemineral density in mice. Five groups of mice (about 6 mice per group)are used in these experiments. The treatment groups are as follows: (I)untreated negative control mice; (II) mice treated with a blockinganti-SOST monospecific antibody that is known to increase bone mineraldensity on its own (positive control); (Ill) mice treated with abispecific antibody that specifically binds CD63 and SOST but does notinhibit SOST activity on its own or only slightly inhibits SOST activityon its own; (IV) mice treated with an anti-CD63 parental antibody (i.e.,a monospecific antibody containing the same anti-CD63 antigen-bindingdomain as in the bispecific antibody); and (V) mice treated with ananti-SOST parental antibody (i.e., a monospecific antibody containingthe same anti-SOST antigen-binding domain as in the bispecificantibody). The amount of antibody administered to the mice in each groupis about 10 to 25 mg/kg.

It is expected that mice in group III (treated with ananti-SOST×anti-CD63 bispecific antibody) will exhibit an increase inbone mineral density that is at least comparable to that which isobserved in the mice of group II (treated with a known blockinganti-SOST antibody), even though the anti-SOST component of thebispecific antibody does not inhibit SOST activity on its own (asconfirmed by the mice in Group V which are expected to not exhibit anincrease in bone mineral density). The increase in bone mineral densitythat is expected in the mice of group III is believed to be driven byCD63-mediated internalization of SOST, as observed in the cellularexperiments of Example 4, above.

Example 6 Cellular Internalization of Lipopolysaccharide (LPS) Mediatedby a Multispecific Antigen-Binding Molecule that Simultaneously BindsLPS and CD63

This Example illustrates the use of a multispecific antigen-bindingmolecule of the invention to direct the internalization of a non-proteintarget molecule, namely lipopolysaccharide (LPS). LPS is a component ofthe outer membrane of Gram-negative bacteria and is known to contributeto septic shock. Anti-LPS antibodies have been investigated as possibletreatment agents for sepsis. The experiments of the present Example weredesigned to assess the ability of a multispecific antigen-bindingmolecule to promote the internalization of LPS.

The multispecific antigen-binding molecule used in this Example was abispecific antibody with one arm directed to LPS (target) and the otherarm directed to CD63 (internalizing effector protein). The anti-LPS armwas derived from the antibody known as WN1 222-5. (DiPadova et al.,1993, Infection and Immunity 61(9):3863-3872; Muller-Loennies et al.,2003, J. Biol. Chem. 278(28):25618-25627; Gomery et al., 2012, Proc.Natl. Acad. Sci. USA 109(51):20877-20882; U.S. Pat. No. 5,858,728). Theanti-CD63 arm was derived from the H5C6 antibody (see Example 4). Theanti-LPS×anti-CD63 bispecific antibody (i.e., multispecificantigen-binding molecule) was assembled using the so-called“knobs-into-holes” methodology (see, e.g., Ridgway et al., 1996, ProteinEng. 9(7):617-621).

Two LPS species were used in these experiments: E. coli LPS andSalmonella minnesota LPS. Both versions were obtained asfluorescent-labeled molecules (ALEXA-FLUOR®-488-labeled LPS, LifeTechnologies, Carlsbad, Calif.).

Experiments were conducted as follows: HEK293 cells were plated in96-well PDL-coated imaging plates. After overnight rest, media wasreplaced with fresh medium. Fluorescently labeled LPS (either E. coli-or S. minnesota-derived) was added in regular medium. Next, theanti-LPS×anti-CD63 bispecific antibody, or control half-antibodiespaired with dummy Fc, were added to the samples. Following variousincubation times at 37° C. (1 hour and 3 hours) or on ice (3 hours),cells from the LPS-treated samples were processed as follows:washed—quenched with anti-ALEXA-FLUOR®-488 antibody—washed & fixed. Theanti-ALEXA-FLUOR®-488 antibody quenches fluorescence fromnon-internalized (i.e., surface bound) fluorophore. Thus, anyfluorescence observed in the quenching antibody-treated samples is dueto internalized LPS. The level of fluorescence from each sample at thevarious time points was measured.

FIG. 9 expresses the results of these experiments in terms of the numberof labeled vesicles per cell. As shown in FIG. 9, only cells treatedwith the anti-CD63×anti-LPS bispecific antibody demonstrated significantnumbers of labeled vesicles that increased over time. Cells treated withlabeled LPS and the control antibodies did not exhibit appreciablenumbers of fluorescent vesicles, indicating that LPS was notinternalized under those treatment conditions.

This Example therefore demonstrates that an anti-LPS×anti-CD63bispecific antibody causes internalization of LPS into cells in a mannerthat requires simultaneous binding of LPS and CD63. Accordingly, theseresults support the use of multispecific antigen-binding molecules ofthe invention to promote cellular internalization of target moleculessuch as LPS for the treatment of diseases and disorders such as sepsis.

The present invention is not to be limited in scope by the specificembodiments describe herein. Indeed, various modifications of theinvention in addition to those described herein will become apparent tothose skilled in the art from the foregoing description and theaccompanying figures. Such modifications are intended to fall within thescope of the appended claims.

What is claimed is:
 1. A multispecific antigen-binding moleculecomprising: a first antigen-binding domain (D1); and a secondantigen-binding domain (D2); wherein D1 specifically binds a targetmolecule (T); and wherein D2 specifically binds an internalizingeffector protein (E); wherein the simultaneous binding of T and E by themultispecific antigen-binding molecule attenuates the activity of T to agreater extent than the binding of T by D1 alone.
 2. The multispecificantigen-binding molecule of claim 1, wherein E is a cellsurface-expressed molecule that is directly internalized into the cell.3. The multispecific antigen-binding molecule of claim 2, wherein E isselected from the group consisting of CD63, MHC-I, Kremen-1, Kremen-2,LRP5, LRP6, transferrin receptor, LDLr, MAL, V-ATPase, and ASGR.
 4. Themultispecific antigen-binding molecule of claim 2, wherein D2 comprisesa ligand, or portion of a ligand, that specifically binds E.
 5. Themultispecific antigen-binding molecule of claim 1, wherein E is asoluble ligand that is internalized into a cell via the interactionbetween E and an internalizing cell surface-expressed receptor molecule.6. The multispecific antigen-binding molecule of claim 5, wherein E istransferrin or a portion thereof that is capable of binding tomembrane-expressed transferrin receptor.
 7. The multispecificantigen-binding molecule of claim 5, wherein D2 comprises a receptor, orligand-binding portion of a receptor, that specifically binds E.
 8. Themultispecific antigen-binding molecule of claim 1, wherein T is a cellsurface-expressed target molecule.
 9. The multispecific antigen-bindingmolecule of claim 8, wherein T is selected from the group consisting ofIL-4R, IL-6R, PRLR, Nav1.7, GCGR, and HLA-B27.
 10. The multispecificantigen-binding molecule of claim 8, wherein D1 comprises a ligand, orportion of a ligand, that specifically binds T.
 11. The multispecificantigen-binding molecule of claim 1, wherein T is an intracellularprecursor of a secreted or transmembrane protein.
 12. The multispecificantigen-binding molecule of claim 1, wherein T is a soluble targetmolecule.
 13. The multispecific antigen-binding molecule of claim 12,wherein T is selected from the group consisting of IL-4, IL-6, IL-13,SOST, and DKK1.
 14. The multispecific antigen-binding molecule of claim12, wherein D1 comprises a receptor, or ligand-binding portion of areceptor, that specifically binds T.
 15. The multispecificantigen-binding molecule of claim 1, wherein D1 and/or D2 exhibitspH-dependent binding to its antigen.
 16. The multispecificantigen-binding molecule of claim 15, wherein D1 binds T with loweraffinity at acidic pH as compared to neutral pH; and/or wherein D2 bindsE with lower affinity at acidic pH as compared to neutral pH.
 17. Themultispecific antigen-binding molecule of claim 1, wherein D1 and/or D2comprise(s) at least one antibody variable region.
 18. The multispecificantigen-binding molecule of claim 17, wherein D1 and/or D2 comprise(s) aheavy chain variable region (HCVR) and a light chain variable region(LCVR).
 19. The multispecific antigen-binding molecule of claim 18,wherein the multispecific antigen-binding molecule is a bispecificantibody.
 20. The multispecific antigen-binding molecule of claim 1,wherein D1 is derived from an antigen-binding molecule that binds butdoes not substantially inactivate T on its own.
 21. A method forinactivating or attenuating the activity of a target molecule (T), themethod comprising contacting T and an internalizing effector protein (E)with a multispecific antigen-binding molecule, wherein the multispecificantigen-binding molecule comprises a first antigen-binding domain (D1)and a second antigen-binding domain (D2), wherein D1 specifically bindsT, and wherein D2 specifically binds E; and wherein the simultaneousbinding of T and E by the multispecific antigen-binding molecule causesinactivation of T to a greater extent than the binding of T by D1 alone.22. The method of claim 21, wherein E is a cell surface-expressedmolecule that is directly internalized into the cell.
 23. The method ofclaim 21, wherein E is a soluble ligand that is internalized into a cellvia the interaction between E and an internalizing cellsurface-expressed receptor molecule.
 24. The method of claim 21, whereinT is a cell surface-expressed target molecule.
 25. The method of claim21, wherein T is a soluble target molecule.
 26. The multispecificantigen-binding molecule of claim 1, wherein D2 comprises anantigen-binding portion of an anti-CD63 antibody.
 27. The multispecificantigen-binding molecule of claim 26, wherein D1 comprises anantigen-binding portion of an anti-IL-4R antibody.
 28. The multispecificantigen-binding molecule of claim 26, wherein D1 comprises anantigen-binding portion of an anti-SOST antibody.
 29. A multispecificantigen-binding molecule comprising: a first antigen-binding domain(D1); and a second antigen-binding domain (D2); wherein D1 specificallybinds a target molecule (T); and wherein D2 binds an internalizingeffector protein (E); wherein T is a tumor-associated antigen; andwherein the simultaneous binding of T and E by the multispecificantigen-binding molecule causes internalization of the multispecificantigen-binding molecule into a tumor cell.
 30. The multispecificantigen-binding molecule of claim 29, wherein the multispecificantigen-binding molecule is conjugated to a drug, toxin or radioisotope.31. The multispecific antigen-binding molecule of claim 29, wherein D2binds E with low affinity.
 32. A method of targeting a tumor in asubject, the method comprising administering to the subject themultispecific antigen-binding molecule of claim 29, and a secondantigen-binding protein that specifically binds T at an epitope that isnon-overlapping with the epitope to which D1 binds.
 33. The method ofclaim 32, wherein the second antigen-binding protein is conjugated to adrug, toxin or radioisotope.